Having good communication within a Health and Social Care context is very important as without it patients could be put at risk. This communication can come in many different forms and contexts such as; verbal, non-verbal, group, 1:2:1 formal, informal texting, written and oral. All of those forms are used at different times depending on the age, culture, physical and mental ability of the person you are interacting with.
Effective communication, be it with individuals with physical/mental limitations or a fully able individual, is the delivery of a message or messages using methods that cater for each of their needs.
Logbook;
Date | Who with? | Type of interaction | Subject | 3/9/14 | Brother | Oral, Verbal, Informal, 1:2:1 | Football Match | 3/9/14 | Grandmother | Verbal, Formal (phone call) | First day at college | 3/9/14 | Jess | Non-verbal, Informal (text) | Bus journey | 4/9/14 | Boss | Non-verbal, Formal (e-mail) | Weekend hours | 4/9/14 | Jess, Jess, Kirsty | Verbal, Informal, Group | Classwork |

Task 1
P1;
The first interaction I had was with my brother. This from the outset was clearly informal, as the slang and colloquialisms were used throughout. Although this interaction was one to one it was not as intense as some as we were both watching the football match and the conversation was second thought. Our body language was very relaxed, both of us were slouched on the sofa zoned into the TV; there was no eye contact until ‘half-time’ when we could afford to not be watching the TV. The communication in this interaction was successful as we both got the point we wanted to get across to each other clearly and effectively.

The second interaction I had was with my Grandmother. This interaction was very different to my first as not only was it much for formal but also it was over the phone, so I had to take into consideration how quickly she could respond to any question or statement I put out there. Straight away I could tell this interaction was formal as I was very conscious of the pronunciation and structure of everything I said, this was done purely to make the conversation easier for my Grandmother as she suffers from Parkinson’s disease. Although she may sound as if she struggles to maintain fluidity when speaking this is purely down to the disease, what she wants to say is all there in her head but the challenge is forming it and saying it. In this instance I had to give her time to process every bit of her response, and not rush her. To make this easier I made the effort not to pack a sentence with too much detail, instead each one had a subject and a point or two but never any more or it would have been very difficult for her to respond as she would only be able to focus on the last thing I had mentioned. This interaction was fairly effective as I believe my Grandmother understood the majority of what I was saying, but obviously with this being over the phone it is hard to tell how much she understood as you can’t see facial expressions and with her it is hard to pick up on her tone of voice because everything seems to just be a struggle to say.

The third interaction I had was with a friend. This was very informal much like my first interaction, as well as being informal it was non-verbal as it was done over text. There was a real difficultly to tell whether or not the message was fully understood by the recipient. I could tell that this conversation was informal as all that was said was done in blatant text language e.g. instead of typing ‘you’ it would be ‘u’. This is mainly to save time as the form of text is meant to be a quick and efficient communication form, and minimal effort is meant to be used. This interaction was effective as we both understood what each other had said, this was established the next day when we saw each other, and we both checked that the other had actually understood what was said. The only problem that occurred was that I had to question her about one of the things she had said because I didn’t know whether she was joking or not. This occurs frequently when texting because you can’t see basic facial expressions you rely on when speaking with someone face to face, for example you can’t see if they laugh as something that you intended to be funny.

The fourth interaction I had was with my boss about the hours I would be working at the weekend. This was a very formal conversation as when talking to some older than me who has the ability to sack me if I do something wrong it is essential for me to speak proper English. This interaction was non-verbal as it was done over an e-mail. Within the e-mail I sent I do not think there was anything that could have been misinterpreted as at no point did I say anything that was meant to be a joke, so I would say this interaction was very successful because we both understood what each other meant and wanted, I was trying to negotiate my hours but he wanted me working as long as I could because he doesn’t need me next weekend.
The final interaction I had was with a group of my friends. This was verbal, very informal and obviously in a group. It was clear that it was informal as again slang was used, adequate sentence structure was non-existent and there was a frequent use of bad language. The conversation although it was informal it did have structure, no one was ever competing to talk as we all just took our turn, and if you had an opinion on what someone said then we would wait till they had finished and then say what we wanted to. This interaction was effective as we all got our points across without out interruption and also without being offended by anyone, very little effort was needed with this conversation as none of us struggle with basic communication forms.

The communication cycle was only used when I was talking to my Grandmother and my boss, because with both with both I had to be careful with how I worded everything. With my Grandmother I had to make a conscious effort not to overload a sentence with too much and with my boss I had to make sure that all I said was appropriate for him to read. With both I had to think how I would say everything so that there was no chance of it being misunderstood. In the rest of my interactions the communication cycle was used but as second nature as the people I was interacting with I knew would understand and if they didn’t it was easy for them to question me on what I meant.

P2;
If you consider both Argyles (1972) and Tuckman’s (1965) theories they both help to explain effective communication. On the surface when having a conversation you don’t think into it very much you just get on with what you want to say and who you are saying it to, but when you look in depth alongside both theories each step they suggest makes perfect sense.
Argyles Communication Cycle is what we do in every conversation, but most of the time we do it without knowing, but when you are faced with a new challenge (e.g. a different audience) you have the think about each step much more before saying anything. The concept of the ‘Communication Cycle’ makes it clear that, in order to have effective communication, it must be a two way process. As well as transferring messages to others in a definite, clear way, health care professionals must be able to respond to the verbal feedback as well as the non-verbal feedback. So, effective communication has to involve effort from both participators in the communication.

Tuckman’s theory is easy to relate to and understand when you think about meeting a new group of people, because it is mainly associated with group interactions. Much like Argyles theory it happens without you being aware of it as it is natural. This theory has five phases; forming, storming, norming, performing and transforming (adjourning).
As I mentioned Tuckman’s theory is only for groups but Argyles theory can be used not only with groups but also 1:2:1. Both of the theories can be used formally and informally.
Both theories would help in a Health and Social Care context as I believe in order to put Argyles theory into place you need to have formed some sort of bond in the way that Tuckman’s theory suggests in order to know how work Argyles theory effectively. I think you need to have at least got to stage three (storming) of Tuckman’s theory in order to know how to ‘code’ a message that your patient will be able to understand.
The ‘Communication Cycle’; how it works… 1.) You think of something you want to communicate about to someone else. * For example you may want to suggest something to someone. 2.) You then consider what you are going to say, how you’re going to say it and what form you will communicate this message in. * For example you may use sign language, simple gestures or spoken word. 3.) You then send the message. * This is done in the form that you chose, that whoever you are caring for will understand. 4.) The other person notices that you’ve sent the message. * For example your patient could respond with a facial expression, nodding or words. 5.) The person you are communicating with then needs to decode/interpret your message using their own knowledge. 6.) By this point the message should be understood by the other person, by communicating clearly. * For example, giving feedback. Then the cycle starts all over again.
What does Tuckman’s theory tell us?
Tuckman’s theory (1965) shows us a clear five step process of forming the ‘perfect’ group. The phases are not to be perceived as sequential as each group is different, depending on your group these steps could come in any order as to begin with a group can be messy, this is not to say that it would be wrong for a group to form in the order Tuckman displays.
Forming
Forming
Transforming
Transforming
Performing
Performing
Norming
Norming
Storming
Storming

Task 2
P3;
One of the factors that can influence communication and interpersonal interaction in a health and social care environment could be background noise. This makes it incredibly hard to concentrate as you are more than likely to get distracted by the conversations of those around you. If it is you that gets distracted the person you are meant to be talking to may think you are just being rude or you are not interested. Background noise could be anything from another group’s conversation to the noise of a washing machine in action. Equally if there is no background noise then those in the conversation may feel very under pressure and that there is no escape from the conversation.

Another factor that could influence communication is the lighting. If the room or place that you are in is too bright it may make people have headaches, of course if you have a head ache this will decrease you focus on everything. On the other hand if the lighting is too dim then it may make people feel very tired and also with dim lighting you will find it harder to see the facial expressions of the person or persons you are talking to.

Another common factor that’ll influence communication is the temperature of your surroundings. If it is too hot like the lighting it could make you feel very relaxed but maybe too much to the point of you feeling sleeping, if you were to feel sleepy it would be very hard for you to maintain good posture, eye contact and even a simple conversation. If your surroundings are too cold though it will be equally as hard, concentration will be a big difficultly and your body language would most likely become rather closed in order to retain body heat.

Another factor that can influence communication and interpersonal interactions in a health and social care environment could be the other person’s body language. Your body language could either be far too welcoming or really off putting both making a barrier of communication. If you are too welcoming it could freak the other people out, and make them feel very uncomfortable. Equally if you have a closed posture (e.g. arms crossed) you will make the other person feel very unwelcome and they could feel as if what they are saying is wrong or offending them, as well as that it just makes you look very rude.

Another very common factor that influences communication and interpersonal interactions could be someone’s accent or the language they speak. One’s accent could present major communicational difficulties, misunderstanding them would be very common especially if you partially trying to guess what they are saying, to overcome this problem it would be useful to get a translator in when conversing with someone who has an accent or speaks a different mother tongue.

Another factor that could influence communication within a health and social care environment could be the distance you are away from the person you are talking to. If you are too far away from them you would have to speak louder and this could come across as being aggressive, but equally if you are to close it could be intimidating and very off putting from the other person. It is therefore it is key to find a mutually agreed distance that works for both/all people involved.

It is also very important to think about volume, tone and pitch of your voice when conversing with anyone.

P4;
All of the factors that influence the effectiveness of communication and interpersonal interactions can be very easily overcome with a little bit of thought

The first factor mentioned was background noise, to overcome this you should find a suitable place to talk to someone depending on what you are talking about. For example if you were telling someone they were terminally ill, it would be inappropriate to do so in a loud waiting room, therefore you could take them into a consulting room which is much calmer, with little background noise.

The second factor mentioned was lighting, in order to overcome this factor you need to take into consideration the people you are talking to and what would suit them best. Some people really dislike un-natural lighting so for someone like this you would make sure blinds are as high as possible so that natural light is flooding into the room. Equally some people adore loath natural light, so for this sort of person you would ensure ample lights are turned on in the room. In order to overcome this you need to ask your patient what sort of lighting they prefer. It is common within hospitals and doctors surgeries that the lighting is very intensely bright, this can cause people to have headaches which will then lead to a loss of concentration, so it is important you find out the sort of lighting that benefits your patient most.

The third factor mentioned was temperature, again this is down to personal preference, but also it would be very common that a cold room will make people lose focus as all they can think about is keeping warm, equally a warm room can make people feel very sleepy. To overcome this factor the easiest thing to do is ask your patient if the temperature of the room suits them, if it isn’t you make adjustments accordingly. If a room is too hot you should open windows and turn on air conditioning, on the other hand if a room is too cold then you should close open windows and possibly turn on heating. Obviously it is key to keep your patients happy but also you need to maintain a healthy environment, so once that patient has left you should reverse all things done to windows and heating so that the room gets adequate air flow.

The next factor mentioned was body language. You need to know that each patient is different so the body language that may make one person feel at ease could make another patient feel very uncomfortable and unwelcome. One person may appreciate the use of facial expressions but others may think they are weird and patronising. So people depend on body language to understand the tone and meaning of what you are saying, so for people like this body language is key. Others may be perfectly find understanding spoken words and would find it annoying and distracting with excessive body language and facial expressions. Most of the time to make someone feel comfortable with your presence, an open posture will do that, they should therefore feel comfortable and able to talk to you in confidence. The opposite would be a seen as rude, that would consist of crossed arms and little eye contact. If you were to be sat with a closed posture it would make your patient feel as if you didn’t want to talk to them and that you’re really not interested. As well as adjusting your body language from patient to patient you need to be able to read other peoples body language. For example if you were telling someone that had cancer that their treatment did not work, you wouldn’t expect them to have an open posture they are more than likely to be slumped over, eyes on the floor and no eye contact. This is not because they don’t want to talk to you it is because they are not in a good place.

Another factor that can influence communication and interpersonal interactions is ones accent or mother tongue, quite simply to overcome this you could get an interpreter or a translator to come and sit in your conversation to make communication easier for both sides. People tend to be happier and more comfortable when speaking in their mother tongue and this can be done when you have a translator. If your patient does not seem happy to have a translator, it could just be that speech needs to be slowed down, simplified or presented in another way.

The next factor was distance. When having a conversation with anyone in a Health and Social Care context you need to be aware of the distance between you and the person you are talking to. For example if you are talking to a colleague of yours about a very ill patient and you are at opposite sides of the room it would be inappropriate because everyone else would hear, you would need to move closer. On the other hand if you are talking to a patient being really close to them would be inappropriate and would make them feel uncomfortable. The overcome the factor of distance you need to think about the space between you and whoever you are conversing with. This factor is down to personal preference too. So you could set up two chairs prior to an appointment, and then when your patient comes in ask them if they feel comfortable with the distance between the two chairs.

M2;
The first strategy that was mentioned was in relations to overcoming the barrier of background noise. To overcome this it would be advised to move away from whatever is causing the noise or turn off the object that is making the noise.

An example of background noise could be the use of an air conditioning unit, there are three ways in which the background noise could be decreased; you could turn down the power of the unit if it was on a high level, you could completely turn off this unit but it may have been on with strict instructions not to do so the other alternative would be to move away from the source of noise, you could relocate into another room, as a result you patient would most probably feel much more at ease and they would not be put off by the noise.
You should try to alter the intensity of the noise before you try and relocate as it’ll be less of a hassle to stay in the same room. Of course if the alterations of any device causing background still does not help then relocation would be the only other option. Equally before you see a patient you should assess whether anything will cause major background noise, this will then hopefully decrease the need to move about for each patient.

The next factor was lighting and strategy to overcome this was to alter the light intensity. This could be done both before you see a patient but equally it could be down to personal preference so it would be advisable to ask you patient whether the lighting suits them or not. If the alterations of the lighting still do not satisfy your patient then depending on the circumstance you could relocate and go outside, but of course if they are incredibly ill then this would not be a possibility. Unlike many other factors there is not actually that much that you can do to change it. If you are lucky enough to be able to change the intensity then you could do so, but most lights simply have an on/off switch so there is no way of changing the intensity.

Temperature was the next was the next possible barrier than could occur in a health and social care setting and to overcome this it was mentioned that you could make alterations to the temperature control units such as air conditioning and heating. A simpler form of this would be the opening and closing of windows. The temperature of an environment is the most common barrier of communication and can prove to be an obstacle, as hot and cold temperatures can divert concentration. Instead of focusing on the message being communicated, you will find yourself thinking "I'm too hot" or "I'm too cold" if the temperature of the environment does not meet your satisfaction. Much like lighting there are not that many ways in which you can alter the temperature of an environment, as well as opening and closing windows you could offer a beverage to your patient. If it was hot you would offer them a chilled glass of water and if it was too cold then a hot beverage could be provided.

Language was the next factor that can become a barrier to communication. In order to overcome this obstacle it can be very useful for the understanding of both sides if you slow your speech down, not to the point of being patronising but simply so that everyone in the interaction can understand. You should also frequently ask for clarification, you should make the other person feel comfortable asking you to repeat yourself if they were to not understand. It would also be advisable to possible communicate in more than one form in the hope that at least one form would be understood. When talking to someone who does not speak the same language you should avoid the use of ‘jargon’. It is also very important to be patient with person you are interacting with because they will not be as quick to understand what you are saying as someone who can speak the same language as you.
If the barrier is too great then it would be advisable to get a translator or an interpreter.

M3;
In the 1:2:1 interaction that I performed on 10th September 2014, we mimicked a ‘Pre-Surgical Check’ with a partner. This interaction was verbal and very formal.

All in all the interaction very well, as all the questions I had to ask as the ‘Doctor’ were answered and we both spoke an equal amount. It was clear that this interaction went well as after we had performed it we were asked questions about it and we could both answer all of them, this shows we both listened to each other well. To show that I was listening to my partner I maintained eye contact throughout the interaction. The eye contact was no too intense as I had to make notes so the eye contact would break when I had to look down at my paper. I attempted to write the notes quickly so that I could return to showing my interest to the ‘patient’.

As I mentioned before we both contributed to the interaction equally, this was done by me asking my partner questions. By doing this she would answer making this interaction not so one sided. Equally my partner had the opportunity to ask me questions. This was done by me saying “Do you have any concerns about your procedure?” By doing this not only did it make the conversation tow sided it also made me aware of what she was worried about (relating to the ‘hip replacement’ she was going to have). If I had to say someone that said slightly less it would have been the ‘patient’, this was purely because she chose to nod along in most circumstances as opposed to responding with a sentence or two.

In order to move the conversation forwards I asked the patient questions, and in addition to her response I would reassure her. When the patient displayed concern for her safety during the procedure I would reassure her that no pain can be felt when it is being done. As well as the use of question the patient occasionally went off on a slight tangent about stories she had heard about hip replacements going wrong, again I had to pull her back to reality and tell her that it is a minority of people that encounter issues during this very mundane procedure.

In my opinion I believe the 1:2:1 interaction was very successful, as we answered and all questions. The sheet that we had to fill out as the doctor was filled out in detail with no gaps. We both listened well to each other, eye contact was professional. As I mentioned this interaction was formal, this was made clear by the firm hand shake between us at the beginning and the end of our conversation, the use of ‘proper English’ and how we addressed each other ‘Doctor’ and ‘Miss’.
All of the ways that I mentioned about this interaction going well were made apparent by the obvious understanding between us.

The difficulties we came across within this interaction was the lack of knowledge, when acting as the doctor it was rather hard to answer questions fully. As I came up with answers I was questioning myself on whether it made sense or not.
e.g. When I was the doctor I was asked…
“What is the percentage of fatalities within this procedure?”
Obviously I had no clue so in this circumstance I had to make something up that sounded believable.
“There is a very small percentage of cases that encounter any issues during this procedure, it is very simple and performed very often.”
Clearly my response was very unprofessional, but this is plainly down to my lack of knowledge and lack of technical terms. I was later asked for a rundown of procedure, again my knowledge let me down because I had no clue what truly happens when you have a hip replacement. Not only did this make me feel rather stupid but it made the interaction seem less believable to anyone listening in.

I would love to come back to this task later on within this course to see how I would deal with it, once I’ve gained more knowledge. By doing this task I have learnt how important it is to speak clearly when in a health and social care environment. The task also taught me how to approach different matter a patient may present and how to make an interaction move forward (by asking questions and answer any questions I could be presented with).

In the group interaction that we performed on 18th September 2014, we had to make a puppet in groups and then present to the rest of the group how we made it, what its purpose was and ask if any of the audience had any questions they desired to ask.

The interaction was fairly successful as we got the point across to the rest of the group, we were able to explain in detail about the creation of our puppet, the concept and engage the audience too. It was made clear to us that this interaction went well because everyone seemed to understand the idea behind our puppet.

In a group environment it is obviously very hard to make eye contact with everyone, so to try and overcome this I would look at one area of the room for a while and then I would move to look at another area. By doing this I made it clear to the audience that I was interested in all of them, not just one cluster. Equally as I looked around I could see that they were always looking at the front, whether they were actually listening I was unsure but they did a good job at maintaining focus at us.

Everyone within our group had an equal chance to speak; we all had a certain bit we were meant to talk about. My job was to ask the audience whether they had any question about eh creation of our puppet, by asking the audience it involved them and also moved the interaction on, because each question lead to a new subject.

One of the members of the group did say slightly more when we were presenting our puppet to the group, this was not because the rest of us didn’t want to speak, it was because she was simply in her element stood in front of a group of people. If I had to say who said least, it would have to be me, this was not because I didn’t know what to say, it was because I felt all point were covered before it got to me. So to try and involve myself that is when I asked the audience if they had questions and then I would try and answer them to the best of my ability.

The things that well in this interaction were the clarity of our presentation, no one had to ask for clarification so I therefore believe we must have done a fairly good job of presenting and speaking properly. I also think that because we all said something even though it was some slightly less than others, we still all got our say and therefore can say it was defiantly a group discussion.

This interaction could have been improved by each member of the group speaking equally, as our presentation was ever so slightly dominated by one member. As well as this to make our presentation better we all needed to be more serious about it, it was hard not to laugh throughout. I think this was mainly down to the fact we were presenting to bunch of people of a similar age and it makes you feel slightly self-conscious, I believe if I was asked to do the same task on a work placement I would do so no questions asked because I would not feel as judged. This is something throughout the duration of this course I wish to work on, so that no matter what setting I am in I can be as professional as possible.

From doing this activity I have learnt that in order to have an effective group interaction it is key to involve everyone, which includes the people speaking and those who you are presenting to. I have also learnt that in order to be taken seriously I need to be taking the task seriously myself, so no laughing.

D2;

Within both of the interactions there were many factors that I felt did and could have influence the effectiveness of the interactions.

In the 1:2:1 interaction although I felt that the conversation went well, there were clearly elements that could have been improved.

In order to improve this interaction it would have been nice to have been somewhere more spacious. We were sat at our desks in the classroom which left us with very little space. I felt that I was too close to the person I was talking to, and if it was in a proper situation I as the patient would be feeling very uncomfortable. Distance is very important is very important, in this case it was far too close together. If I were to have moved my legs at all I would have ended up kicking my pair. This was not a major issue in this circumstance as the person I was paired with I know and we get along, but if it were to be someone I don’t know on one of my work placements for example I could imagine it could be very awkward for both of us.

As well as the issue of space we also had to battle with the continuous background noise from the rest of the class performing the same task. It was very difficult to concentrate on your partner when all you could hear was everyone else’s conversations. I found it very hard not to listen in to everyone else’s conversations; this was because everyone had to speak louder and louder in order to speak over everyone else.

It was also really difficult when being the doctor to answer questions from the patient because we didn’t know any technical terms, so it made it very difficult to give accurate answers to the questions.